Vaginal Birth or C-Section? Pros and Cons for Both

I’ve actually thought about writing on this topic since I found out I was pregnant with twins. I knew that a multiples pregnancy increased my chance for a c-section and since I’ve already had a vaginal birth, I wondered if I would be in a position to be able to write it. Well, here we are! Two pregnancies. One vaginal birth and one surgical birth.

So, which would I do again?

Well, none because we are not having any more kids! Ha! But seriously. Which one?

I’ll start with giving a little background on my philosophy of birth from my first pregnancy. I specifically remember watching The Business of Being Born on one couch laying first trimester night and feeling the firm resolve of someone who always has to have a cause that I would absolutely 100% no doubt about it have an unmedicated birth. I got in contact with a doula right away and began to learn as much as possible about natural childbirth. I read books. I practiced breathing techniques. And in the end, I accomplished my goal and my baby and I made it through without complications and zero pain relief. Not even an Advil. You can read my entire birth story here.

Just after giving birth vaginally to my first son with my OB, Dr. Sen.

When I found out I was having twins, I was fully committed to having an unmedicated vaginal birth again. I believed that with the help of my birth team (doula and husband) I would be able to accomplish this goal. Unfortunately, Covid had other plans! At the end of my pregnancy it became clear that I would be giving birth alone and I needed to make a decision about the birth that would keep myself and the babies safe. My hospital and care provider were not the most experienced in supporting twin vaginal births and I was worried about ending up in an emergency c-section anyway as it seemed likely given I would have basically no birth support. I felt that a scheduled c-section would be less stressful and allow me to be well rested after the birth in order to focus on breastfeeding which was very important to me. If you want to know the details, here’s my twin birth story.

The last photo I took of myself before my scheduled c-section.

Of course, your particular situation will play a large part in how your birth plays out. However, I know when I was pregnant, I wanted to be as prepared as possible for every type of birth outcome. From here I will talk about the pros and cons of vaginal and surgical birth.

Vaginal Birth

  • Pros:
    • Generally the safest type of birth, particularly if you do not use an epidural.
    • Freedom of movement throughout your birth so you can make sure baby is engaged in the proper position and use your body to encourage contractions.
    • Your support team is allowed to be with you the entire time in most cases.
    • Baby encounters natural bacteria from the mother as they come through the birth canal which is helps them build their own microbiome from day 1.
    • Less physical recovery. Birth parents are often able to walk and move soon after birth if not right away.
    • Higher rates of breastfeeding success given that recovery is easier and your hormones are changing in the way they are supposed to to induce lactation. Often your milk comes in faster after a vaginal birth than a surgical birth.
    • More options with care providers. Birth clinics and birth houses are options for you unless you are an RH- blood type which means you must be in a hospital in Japan.
  • Cons:
    • Birth can be long and tiring, particularly if you don’t have a good support team or your care provider doesn’t encourage movement.
    • Vaginal birth can still lead to a c-section in some situations if the birth parent’s or baby’s condition deteriorates.
    • Possibility of interventions such as episiotomy, vacuum extraction etc.

Surgical Birth/C-section

  • Pros:
    • Baby is born quickly and safely in a situation where a vaginal birth is not possible.
    • For a planned c-section, you don’t have to go through labor and you will know when your baby will be born.
    • Sometimes baby’s head is a rounder shape since they don’t go through the birth canal.
  • Cons:
    • Surgery, planned or unplanned, can be a very scary experience. Many people experience having the anesthesia not work properly or some other complication during surgery itself.
    • Surgery will always have risks associated with it.
    • Recovery is quite long and can have complications as well. You will not be able to walk right afterward (usually it takes 12-24 hours to be able to stand).
    • Breastfeeding can be difficult and painful for the birth parent and baby may be very sleepy from the epidural and other medicines so it can be hard to get them to latch. It may also take longer for your milk to come in.
    • Your incision may be sensitive or even painful for weeks or months afterward.
    • You are more likely to have future c-sections once you have experienced one.
    • Must give birth in a hospital setting.
    • Depending on your hospital, you may or may not be allowed to have your birth support person with you in the OR.

I think it’s easy to see that surgical births are not an “easy way out” as people like to think. Although vaginal birth can be long and tiring in most cases, usually your recovery afterward is much less arduous than with major abdominal surgery. I definitely encourage people to pursue and prepare for an unmedicated vaginal birth if possible because this will give you the best chance at keeping yourself and baby healthy.

One note on medicated births: Epidurals force you to remain in a bed and stationary in most cases so it can slow down your contractions and increase your chance of having a c-section. For me, this was a major concern and one of the main reasons why I chose to give birth without one. However, I did have an epidural placed during my c-section so that afterward I would have proper pain management.

Have you experienced a vaginal or surgical birth? Both? What would you add to this list?

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